Airdate: June 22, 2017 0min:0sec to 11min:10sec
Senate Republicans released their version of a health care bill to replace the Affordable Care Act. University of Arizona health policy expert Dr. Daniel Derksen will talk about the new plan.
TUCSON (KGUN9-TV) - Senate Republicans postponed the vote on the Better Care Reconciliation Act Tuesday.
"The good part of the discussion going on right now is the people are starting to ask a lot of questions about what will happen to me what will happen to my family," said Daniel Derksen, a University of Arizona College of Public Health professor.
Derksen says 70 million Americans are currently covered by Medicaid and two million of those are in Arizona.
"The estimate is either of these bills would cause about 400,000 Arizonans to lose their Medicaid coverage and be uninsured," he explained.
He says in rural communities, health infrastructure depends on small rural hospitals known as critical access hospitals and these would have a hard time providing services if funding was cut.
"In Arizona we have 14 critical access hospitals and they would be particularly hard hit by these drastic cuts," he said.
Derksen says over the next 10 years, $7.3 billion in Arizona's federal Medicaid funding would be cut and with the loss of funding, nearly 25,000 jobs will be cut from Arizona.
U.S. Senator John McCain says Arizona has been nationally recognized for running one of the most efficient and cost-effective Medicaid programs in the country.
He stated this type of legislation should reward the state, rather than penalize it.
Senator McCain stated he supports repealing and replacing Obamacare, but quote, "I will be working hard to include important measures that address the concerns raised by Governor Ducey and other leaders across our state about the bill's impact on Arizona's Medicaid system."
» See video at link below:
TUCSON.COM | By Stephanie Innes Arizona Daily Star
Jun 26, 2017
The turnout at Tucson Medical Center’s forum about federal health reform Monday night underscored local concern about the issue — there were 700 people, twice what organizers expected.
A livestream of the event on Facebook drew 1,900, organizers added.
“I’m floored,” TMC spokesman Jim Marten said of the attendance numbers. “With the heat and everything. ... We had to keep adding chairs.”
Here are five takeaways from the event:
1. The sentiment at the forum was against both the Senate and House bills.
Judy Rich, CEO of TMC, made it clear at the beginning of the program that she thinks the American Health Care Act (House bill) and the Better Care Reconciliation Act (Senate bill) should be set aside, and that efforts should be made to move to a bipartisan solution that will be better for communities.
The audience members were also predominantly either concerned about both bills or had made up their minds against them. A group greeted attendees with information about a single-payer “Medicare for All” alternative. One woman held a sign that said “Healthcare Not Wealthcare.”
2. The opposition was not solely partisan.
Dr. Dan Derksen, a health-policy expert and professor at the University of Arizona’s Mel & Enid Zuckerman College of Public Health, pointed out impacts that both bills could have, particularly on Arizona’s rural and low-income populations. He said they would be devastating and, after the event, called the proposals “too vindictive.”
But he also disclosed to audience members that he is a lifelong registered Republican.
3. The Senate bill is not too different from the House bill.
Under both bills, Medicaid as we know it could end. And congressional budget reports on both bills predict that under their provisions, more Americans will be uninsured.
» View video on YouTube (Dr. Derksen speaks from 26min:00 sec to 35min:00 sec)
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THE SUNDAY HERALD (Glasgow, Scotland) | Exclusive by Andrew Purcell
June 24, 2017
WITHIN five days, Trumpcare could well be on the US statute books. It hasn't taken long to get there. The journey began on May 4, when the Republican caucus in the House of Representatives gathered to vote on the American Health Care Act (AHCA). For seven years, they had promised to repeal Barack Obama’s signature legislative achievement, but now they had control of both houses of Congress and the White House, they couldn’t agree on a replacement. To conservative hardliners, the bill was too timid. Moderates worried that supporting it could cost them their seats.
Whips played Eye Of The Tiger on the stereo to harden their resolve, and projected an image of General George Patton urging them to "accept the challenge so that you can feel the exhilaration of victory.” Later, once the bill had scraped through 217-213, Republican Congresswoman Ann Wagner said: “The line of the day was out of Braveheart: ‘Freedom!’”
In their minds, these privileged few were Rocky entering the ring, William Wallace leading the charge at Stirling Bridge. Republican Congressman Jason Chaffetz rode in on a scooter, fresh from foot surgery covered by his subsidised government health insurance, to vote for a bill that will make the same operation unthinkably expensive for tens of millions of Americans. If it becomes law, thousands more will die each year because they cannot afford to see a doctor.
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Two policy experts talk to MedPage Today about the no longer secret plan
The Christian Science Monitor| by Francine Kiefer | Staff writer
June 22, 2017
WASHINGTON—Republican senators unveiled their long-anticipated healthcare plan to replace Obamacare on Thursday, and it includes significant changes to Medicaid, the joint federal-state program for the poor, elderly, and disabled.
The bill, which does not yet have the support of enough senators to pass, reflects the ongoing tussle of costs vs. social benefits that sharply divides the two parties as well as Republicans themselves.
Like the Republican legislation that passed the House in May, the draft bill put forward by Senate Republican leaders aims to rein in federal spending on the burgeoning program – a move they say will strengthen it in the long term. But over time, that will mean substantial cuts to some of the country’s highest-need populations, say advocates – though the full scope of those cuts won’t be known until the independent Congressional Budget Office releases its report on the Senate bill early next week.
“Medicaid is fiscally unsustainable,” says Steve Kelly, spokesman for Sen. Pat Toomey (R) of Pennsylvania, the senator who represented the GOP conservative viewpoint on Medicaid as the bill took shape behind closed doors.
Thirty years ago, Medicaid accounted for less than 3 percent of federal spending. Today, it’s nearly 10 percent. About one fifth of the US population is enrolled in it, according to a Congressional Research Service 2015 report. It pays for almost half of all births. It’s the single biggest payer for substance abuse treatment. It helps rural hospitals stay afloat and supports jobs in the health sector. It covers nursing homes for the elderly and long-term care for the disabled.
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Daniel Derksen and Will Humble | AZ We See It
Even if the governor vetoed it, Nevada's plan to allow anyone to buy Medicaid coverage may be the way forward for Arizona and the nation.
Last week, the Nevada state Legislature handed Gov. Brian Sandoval an innovative opportunity to replace the Affordable Care Act at the state level. Unfortunately, he didn’t take advantage of the opportunity.
The Nevada Legislature sent Sandoval a bill that would have allowed any Nevadan to “buy in” to their state’s Medicaid program. On Friday, he vetoed the legislation. Had he signed it, and the Centers for Medicare and Medicaid Services approved the plan, any Nevadan could buy Medicaid coverage — regardless of income.
Why we need 'Medicaid for Many'
Assembly Bill 374 would have directed the Nevada Department of Health and Human Services to ask for a CMS Waiver (called an 1115 waiver) to allow any Nevadan to buy a Medicaid managed care plan. Nevadans eligible for an Affordable Care Act tax credit (called an advance premium tax credit) or cost-sharing reductions based on income could have used them to help pay their share of the premium.
Polling shows that most Americans want reasonably priced health insurance regardless of having a pre-existing condition. Nevada’s Medicaid plan would have done that, avoided a complicated health-system overhaul and could be tailored to fit other state programs.
“Medicare for All” is getting a lot of national attention again these days. Perhaps it’s time to add “Medicaid for Many” to the discussion, as the U.S. Senate is poised to vote on a bill in the next few weeks. Medicaid infrastructure exists in all states.
How it could work in Arizona
Arizona’s Medicaid program, called AHCCCS, operates through a CMS-approved 1115 Medicaid waiver. Medicaid is re-channeled through private health insurers through a multiyear bid process. Insurers compete for the Medicaid business, and are assured of enrollees for several years. Consumers are not subjected to the yearly volatility of changes in price, plans and benefits.
Insurers have time to build a contractual network with participating clinics, physicians, hospitals and other health providers; consumers can make sure their provider is participating. Arizona’s Medicaid program has the eighth lowest per-person expenditures of the 50 states, with two million AHCCCS enrollees among our population of seven million.
To make Nevada’s approach work in Arizona, our Medicaid 1115 Waiver needs amendment and CMS approval. With ACA tax subsidies and cost-sharing reductions, the out-of-pocket costs per person would be less than plans currently offered in Arizona’s Marketplace, with far less year-to-year volatility in pricing.
Let's take this debate nationally
Medicaid payment to hospitals and physicians tends to be lower than even what Medicare pays. To assure that there are enough hospitals, clinics, physicians, dentists and other health providers in the network, insurance vendors offering Medicaid plans would have to negotiate more reasonable payment rates with providers.
Jun 14, 2017 | Mohave Dalily News
PHOENIX (AP) — The only two insurance companies offering individual health plans on federal exchanges in Arizona have filed paperwork to continue selling coverage in 2018, raising hopes that the state can avoid a repeat of last year’s crisis when one county was briefly left without a health insurance provider.
Grants to allow first responders and members of other key community sectors to administer a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
Geographic coverage: Nationwide
Application Deadline: Jul 31, 2017
The Georgetown University Center for Children and Families (CCF) Rural Health Policy Project released Medicaid in Small Towns and Rural America: A Lifeline for Children, Families, and Communities. This report resulted from analysis by researchers from Georgetown and the University of North Carolina Rural Health Research Program and examined "how the role of Medicaid has changed over time in 46 states with small-town and rural populations."
The CCF also developed an interactive map that displays the percent of children in these areas covered by Medicaid in 2014-15.
- Applications Open May 16 – July 17
- 15% Minimum Match Required
- Awards Range from $50k to $500k
- Every State/Region has a General Field Rep who can answer more specific questions. This info is available on Grant Page.
By Stephanie Innes Arizona Daily Star | June 3, 2017
An AARP television advertisement airing in Arizona again this week takes aim at federal health reform and is targeted to U.S. Sen. Jeff Flake.
“As the number of opioid overdoses and deaths increase at an alarming rate, we must take action.”
PHOENIX — Governor Doug Ducey today signed an emergency declaration to address the growing number of opioid deaths in our state.
Newly released data from the Arizona Department of Health Services shows in 2016, 790 Arizonans died from opioid overdoses – an average of more than two people per day. The trend shows an alarming increase of 74 percent over the past four years. Today’s declaration by the Governor directs the Arizona Department of Health Services to rapidly respond to this public health emergency.
“As the number of opioid overdoses and deaths increase at an alarming rate, we must take action. It’s time to call this what it is — an emergency," said Governor Ducey. “Most of us know someone impacted by substance abuse – our family, our friends, our neighbors. Our hearts ache for them, but that isn’t enough. We must do more. I’m declaring a statewide health emergency, because we need to know more about the epidemic, including enhanced data that illustrates when and where these overdoses occur so that we can develop real, targeted solutions.”
The declaration gives the state the ability to coordinate public health efforts between state, local, and private sectors and allow the state to utilize all its public health resources and help put naloxone into the community to help prevent drug overdose deaths. The declaration and enhanced surveillance advisory will provide for enhanced reporting of overdose deaths from doctors and hospitals.
“The only way we will be able to make an impact in the opioid epidemic is to come together as a community and this declaration helps us move forward quickly,” said Dr. Cara Christ, director of the Arizona Department of Health Services. “We will look into helping improve prescribing practices, addressing poly drug use, and analyzing raw data on overdose deaths that occur to see where the problem areas are and learn how we can make changes to save lives.”
As part of this public health emergency the Arizona Department of Health Services will identify ways to:
- prevent prescription opioid drug abuse through appropriate prescribing practices,
- develop guidelines to educate healthcare providers on responsible prescribing practices,
- expand access to treatment, especially Medication Assisted Treatment (MAT), and
- reverse overdoses through the distribution of naloxone.
View a copy of today’s emergency declaration along with information and updates on our progress in turning the tide on the Arizona opioid epidemic here: http://azhealth.gov/opioid.
by Alexandria Bachert | Staff Writer, MedPage Today May 26, 2017
House Republicans and the White House have recently proposed massive reductions in the Medicaid program which could shave more than $1 trillion from projected expenditures over the next 10 years.
Much of the debate over these cuts has centered around the effects on children and the poor, but about 40% of the Medicaid budget pays for long-term care for the elderly, many of whom are poor only on paper. In this edition of “Friday Feedback,” experts discuss the critical role Medicaid plays in the healthcare system, particularly for America’s increasingly numerous seniors, and what might happen if funding is slashed.
…won't budget cuts simply deprive the poor of access to care?
Daniel Derksen, MD, Arizona Center for Rural Health: You don't save money by throwing millions off of coverage. That strategy shifts costs to states, to individuals and their families, and to physicians, hospitals, clinics and nurses through uncompensated and charity care. It strains credulity to cut almost a trillion dollars of federal funding to state Medicaid programs over the next 10 years, and claim that bill gives states more autonomy.